Surgical buttons are used to secure sutures and thereby other surgical items such as grafts to a body part. The use of surgical buttons to secure suture to bone presents particular challenges. A tunnel of significant length is sometimes formed through the bone. The elongated surgical button is dimensioned so as to fit through the tunnel axially, but is longer than the width of the tunnel such that when inserted through the tunnel and rotated the button will engage bone around the tunnel opening. Tension can then be applied to suture engaged to the button to secure the button and the suture in position.
The insertion of the surgical button through the tunnel followed by release and rotation of the button is difficult particularly in minimally invasive procedures where the dimensions of the surgical opening must be minimized. A grasper (plier) is used to grasp the button and push it into the tunnel in the body part. The grasper does not do a very good job of limiting rotation of the button during insertion. The surgeon must open the jaw to release the button in a very limited space. Attempts have been made to address these problems. One design utilized a threaded hole at the proximal end of the button and a threaded rod to engage and insert the button through the tunnel. The buttons are thin so the tapped hole must be small in diameter, and the threaded rod can break off during insertion of the button into the tunnel.